can someone help me understand this developmental vision screening report?

[caedmyn]

I got the results of my 10 YO's developmental vision screening today.  For ocular motility, it said he can adequately perform pursuits eye movements and saccadic eye movements, but his ability to do some other eye movements (it didn't specify what they were called) was very weak.  In the area of accomodation/eye focusing, it said he has some difficulty rapidly shifting focus from distance to near, and focusing at near for sustained periods of time.  In the area of binocular integration/eye teaming, it said he had moderately decreased stability in eye teaming.  It said he had no problems with visual information processing skills.  They recommend 24-30 sessions of vision therapy to work on these items, at a cost of $120 session along with a 6 hr round trip drive with 6 kids:

Monocular activities designed to equalize the focus, tracking, and pointing of each eye
Binocular work to improve eye-teaming efficiency while focusing, tracking, and pointing
Guided reading therapy to improve the eye tracking, eye teaming, and speed of fluent reading
Visual-spatial tasks to develop integrated sequential and directional concepts
Visual motor tasks to improve body awareness and control, visually directed fine and gross motor skills, and hand-eye coordination
Inter-sensory integration skills through visual-auditory-verbal matching

The original information I received when we did the screening was that they have 9 areas related to vision that they work with, so they are still wanting to work with him on 6 of those areas, and also that they typically recommend 30-36 sessions of VT.  What they're recommending for my 10 YO seems like overkill to me.  They're basing his need to work on spatial awareness on getting a low score on a test of reversal frequency recognition, and on being slow to copy sentences in another test.  Is it even reasonable to expect a dyslexic child to do well on those particular tests?  They were told that he's dyslexic.  I also don't understand why he would need to work on inter-sensory integration if his visual-sensory integration tested as being strong to very strong. 

They said some people do bi-weekly sessions instead of weekly, but still require the same number of sessions, which doesn't entirely make sense to me because what's the purpose of doing two weeks worth of homework if it's not actually improving the outcome over doing a week's worth?  Why not just do the homework once or maybe twice the second week so no gains are lost?  I'm not sure I'm even willing to do that drive more than once a month except in the summer, but I don't know if they'll work with that.  I can call and ask them some questions on Monday. 

[PeterPan]

What are your options for therapy? Do you seriously live 3 hours from a developmental optometrist? You want to go once a month and be given a pile of homework. You’re very good at making homework happen so you need someone trying to help you do that. It sounds like they want in office time to do stuff they don’t assign as homework. Could you go, stay for a week doing 2 hours s day, and then have homework? 

You’re going to have to talk it through with them. 

[kbutton]

On 10/19/2019 at 7:49 PM, caedmyn said:

I got the results of my 10 YO's developmental vision screening today.  For ocular motility, it said he can adequately perform pursuits eye movements and saccadic eye movements, but his ability to do some other eye movements (it didn't specify what they were called) was very weak.  In the area of accomodation/eye focusing, it said he has some difficulty rapidly shifting focus from distance to near, and focusing at near for sustained periods of time.  In the area of binocular integration/eye teaming, it said he had moderately decreased stability in eye teaming.  It said he had no problems with visual information processing skills.  They recommend 24-30 sessions of vision therapy to work on these items, at a cost of $120 session along with a 6 hr round trip drive with 6 kids:

Monocular activities designed to equalize the focus, tracking, and pointing of each eye
Binocular work to improve eye-teaming efficiency while focusing, tracking, and pointing
Guided reading therapy to improve the eye tracking, eye teaming, and speed of fluent reading
Visual-spatial tasks to develop integrated sequential and directional concepts
Visual motor tasks to improve body awareness and control, visually directed fine and gross motor skills, and hand-eye coordination
Inter-sensory integration skills through visual-auditory-verbal matching

Do they do body work? The bolded suggests convergence issues to me, and that means bodywork. It sounds like they do other work to improve bodywork outcomes, but they should be doing bodywork to improve the VT outcomes. Getting convergence fixed is HUGE. It's awfully hard to know what focus can be sustained for near work with convergence issues, so I would take the accommodation comments with a grain of salt. Now, that said, he could still have sluggishness there after fixing convergence because his brain needs some practice, but that's not something that's impossible to overcome. 

I don't know what the monocular activities are, but my son did a bit of stuff with a patch on and then with the eye unpatched. But it was very little and moved toward binocular activities very quickly.

There is a computer program for convergence that has some evidence basis. You do it at home. I have heard it recommended when you might have a sketchy doc or can't make a drive.

We had homework with VT and were through the program in a shockingly short period of time. 

Maybe you can ask if you can do homework and come less often as Peter Pan suggested, AND if you could work exclusively on convergence first. Then see how things go from there. 

I don't know why the underlined is recommended if he's doing fine with visual information processing skills. If the child is dyslexic, I think the guided reading tasks could be difficult, but I don't know since I don't know what they are.

There are books you can follow up with at home for more of the visual processing practice if you got convergence fixed. 

[caedmyn]

On 10/21/2019 at 10:14 AM, kbutton said:

Do they do body work? The bolded suggests convergence issues to me, and that means bodywork. It sounds like they do other work to improve bodywork outcomes, but they should be doing bodywork to improve the VT outcomes. Getting convergence fixed is HUGE. It's awfully hard to know what focus can be sustained for near work with convergence issues, so I would take the accommodation comments with a grain of salt. Now, that said, he could still have sluggishness there after fixing convergence because his brain needs some practice, but that's not something that's impossible to overcome. 

I don't know what the monocular activities are, but my son did a bit of stuff with a patch on and then with the eye unpatched. But it was very little and moved toward binocular activities very quickly.

There is a computer program for convergence that has some evidence basis. You do it at home. I have heard it recommended when you might have a sketchy doc or can't make a drive.

We had homework with VT and were through the program in a shockingly short period of time. 

Maybe you can ask if you can do homework and come less often as Peter Pan suggested, AND if you could work exclusively on convergence first. Then see how things go from there. 

I don't know why the underlined is recommended if he's doing fine with visual information processing skills. If the child is dyslexic, I think the guided reading tasks could be difficult, but I don't know since I don't know what they are.

There are books you can follow up with at home for more of the visual processing practice if you got convergence fixed. 

By bodywork do you mean exercises for retained reflexes, or something else?

[kbutton]

41 minutes ago, caedmyn said:

By bodywork do you mean exercises for retained reflexes, or something else?

Yes, but also things that integrate vision with body movement, particularly bilateral coordination activities.